Pulmonary Hypertension Diagnosis in Humans
The pulmonary hypertension diagnosis is rarely found in the early stages because it is rarely found during routine physical examination. At an advanced stage, the disease is also difficult to find because of symptoms that resemble other heart and lung diseases. At the beginning of the examination, the doctor may ask about the symptoms experienced, the history of the same disease in the family, the patient’s medical history and the drugs being consumed by the patient. The doctor may also perform a physical examination by looking at swelling of the feet or ankles and listening to heart and breath sounds using a stethoscope.
Some preliminary examinations and support tests that doctors may recommend to confirm the diagnosis and to know the severity of pulmonary hypertension are:
- Blood tests are performed to check for the presence of certain substances in the blood that indicate pulmonary hypertension or its complications, as well as other diseases.
- Examination of lung function performed to determine the endurance of the lungs to the air and how well the flow of air coming in and out of the lungs through a device called a spirometer.
- An electrocardiogram (EKG) examination will show the electrical waves of the patient’s heart. Electrocardiogram in patients with pulmonary hypertension will show symptoms of irregular heartbeat, tension, or swelling of the heart chambers.
- An X-ray examination of the chest may also indicate a swelling in the right ventricle of the heart or lung vasculature that is a symptom of pulmonary hypertension.
- Echocardiogram examination produces images through sound waves to determine the size and how well the heart, including the thickness of the right ventricular wall of the heart. The patient may also have an echocardiogram before and after physical activity to find out how well the heart and lungs are performing under pressure, as well as on the carbon dioxide and oxygen content.
- Right heart catheterization is generally performed after the patient undergo an echocardiogram examination to confirm the diagnosis of pulmonary hypertension while also knowing the severity of the condition. This procedure is also used to determine the effect of different treatment on pulmonary hypertension that has been used. In this procedure, the catheter will be inserted into the right ventricle via a vein in the neck or groin area.
- CT scans and MRI scans are used to obtain a clearer picture of the size and function of the cardiac organ, the clotting of blood vessels, and the blood flow in the pulmonary vasculature.
- Polysomnograms are used to observe blood pressure and oxygen, heart rate, and brain activity during sleep. This tool is also used to recognize sleep disorders, such as sleep apnea.
- V / Q scan or ventilation-perfusion scan is done by inserting a tracking device into the vessel in hand via injection. The device will track the flow of blood and air to the lungs and detect whether there is a blood clot that causes pulmonary hypertension.
- Pulmonary biopsy is open to taking samples of lung tissue by making a wedge between the ribs. This procedure is generally done because other biopsy procedures are unsuccessful or not possible, or the required tissue is too large.
- A genetic test was performed to determine if the patient had the same genes as other family members after the doctor reviewed the history of pulmonary hypertension in the family history. Your doctor may suggest genetic tests on other family members if your test results are positive.
Several classifications of the diagnosis of pulmonary hypertension that can be given to the patient after the doctor gets the results of the series of checks that have been done are:
- Class 1. Patients diagnosed with pulmonary hypertension, but without symptoms and can still move normally.
- Class 2. Patients who experience symptoms of fatigue, discontinuous breathing, or chest pain when performing normal activities, but not while resting.
- Class 3. Patients who experience symptoms during physical activity that is lighter than normal, but still normal or no symptoms when resting.
- Class 4. Patients experience symptoms, both during physical activity and when resting.